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Here, we exploit the modular organization of patient-derived TTR fibrils to investigate two components of the pathological core: an N-terminal \u03b2-hairpin spanning residues 11\u201335 (N-TTR) and a larger C-terminal fragment spanning residues 57\u2013123 (C-TTR). Both fragments independently form \u03b2-rich amyloid fibrils, as demonstrated by electron microscopy, circular dichroism, and fluorescence spectroscopy. Yet, their activities differ markedly. N-TTR fibrils promote full-length TTR aggregation and seed in an engineered cellular biosensor platform established to detect templated TTR assembly, whereas C-TTR aggregates show no detectable templating activity. Cryo-electron microscopy reveals two N-TTR polymorphs that preserve structural features of disease-derived folds, while energetic profiling identifies N-TTR as a stabilizing hotspot within ex vivo structures, providing a basis for this templating functionality. These findings reveal a functional hierarchy among amyloidogenic segments of TTR, since distinct regions form fibrils independently, but only those with structural compatibility efficiently template the parent protein. N-TTR therefore represents an autonomous amyloidogenic segment that links local sequence propensity to TTR nucleation, templating, and fibril polymorphism.<\/jats:p>","DOI":"10.64898\/2026.09.04.749224","type":"posted-content","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T05:25:11Z","timestamp":1788931511000},"source":"Crossref","is-referenced-by-count":0,"title":["An N-terminal ATTR Fibril Segment Promotes Transthyretin Amyloid Nucleation and Polymorphism"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3157-2998","authenticated-orcid":false,"given":"Laxmikant","family":"Gadhe","sequence":"first","affiliation":[{"name":"Center for Alzheimer\u2019s and Neurodegenerative Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA"},{"name":"Peter O\u2019Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA"},{"name":"Department of Biophysics, University of Texas Southwestern Medical 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